Poley Sports Medicine, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

POLEY SPORTS MEDICINE, PLLC

Practice address

15959 Hall Rd Ste 405
Macomb, MI 48044

Phone

(586) 416-6260

NPI assigned

Feb 23, 2018

Last updated

May 25, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Edward Poley, MDNPI 1104038629

Title

Managing Member

Phone

(586) 416-6260

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Edward Poley, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Rochester Hills, MI
  • NPI 1104038629
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527206400000",
    "number": "1255832382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15959 HALL RD STE 405",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445368",
            "telephone_number": "586-416-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15959 HALL RD STE 405",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "48044",
            "telephone_number": "586-416-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4550 Investment Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480986334",
            "country_code": "US",
            "telephone_number": "248-792-9881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POLEY SPORTS MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-05-25",
        "status": "A",
        "authorized_official_last_name": "POLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "586-416-6260",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Pitcher
• Nataha L Pittman
• Michael D Pizzimenti, DPT
• Jessica Pizzo
• Heidi Plotzke, PT, DPT
• Mike Joseph Pollzzie, MPT, OMPT
• Deanna M Poniatowski, D.D.S.
• Rafaa Sameer Poota, RDH
• Tina Marie Porta, COTAL
• Raquel Potter

• Medical Specialty Clinic/Center in Macomb, MI
• Providers in Macomb, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.